Childhood asthma is a critical public health problem of urban centers in the United States and other industrialized na-tions. Population-based and laboratory research studies indicate that psychosocial stress differentially affects asthma expression. Witnessing or experiencing community violence is a psychosocial stressor that results in long-term biologi-cal changes that may in turn contribute to asthma morbidity. This is a review of the literature that examines the expo-sure to violence as a psychosocial stressor that is independently associated with asthma morbidity even after adjust-ment for income, housing, and other adverse life events. In addition to acting as a physiological trigger for the disease, community violence can also impact health behaviors and exposure to other unknown environmental risk factors. This connection leads the authors to suggest that reducing violence and the amelioration of its impact has implications be-yond public health. The City of Boston in Massachusetts serves as the context to contextualize a series of recommenda-tions that may ameliorate and/or prevent asthma incidence and prevalence. The reduction of poverty, unemployment, substandard housing, and high crime/violence rates can have significant health implications for children asthma and a decline on asthma hospitalization.

ABSTRACT: Many studies have shown that correlation between clinical asthma status and asthma-specific quality of life is only weak to moderate. However, this relationship has never been explored to determine whether the weakness is due to noise of measurement or whether quality of life is a distinct component of asthma health status. With a database from three clinical trials (n=763), factor analysis was used to explore the relationships between quality of life, measured by the Asthma Quality of Life Questionnaire (AQLQ), and conventional measures of asthma clinical status (symptoms, airway calibre and rescue b2-agonist use). The analysis revealed that although patients with severe, poorly controlled asthma tend to have worse quality of life than milder, well-controlled patients, overall asthma health status has four components (factors): asthma-specific quality of life; airway calibre; daytime symptoms and daytime b2-agonist use, and night-time symptoms and night-time b2-agonist use. The clean loading of all 21 outcomes onto four distinct and clinically identifiable factors suggests that, although some weakness of correlation between clinical indices and quality of life may be due to noise of measurement, it is mainly attributable to asthma health status being composed of distinct components.

Chlamydophila pneumoniae and Mycoplasma pneumoniae are common pathogens causing acute illness in both the upper and lower airways. Several observations are supportive of a possible causative role of these pathogens in asthma; however, more evidence is required before this becomes meaningful in clinical practice. Atypical bacteria can enhance airway hyperresponsiveness and inflammation, both of which have been associated with exacerbations in patients with preexisting asthma. It is less clear whether the above mechanisms might also be responsible for the development of asthma. Difficulties in accurately diagnosing these infections contribute to such uncertainty. In the present report, evidence of the involvement of Chlamydophila and Mycoplasma infection in the development and the progression of asthma are reviewed.

Abstract: The prevalence of respiratory allergic diseases has been increasing in Southern Africa both in urban and in rural environ-ments. Various factors may contribute toward this situation, namely, exposure to aeroallergens, such as grass pollens and house dust mites. However, other irritant environmental triggers, such as exposure to tobacco smoke and certain indoor and outdoor fumes, may also play a relevant part. Furthermore, certain parasitic and mycobacterial infections may act as allergic disease risk modifiers, although such an influence should be confirmed. Finally, certain cultural and socioeconomic factors may also influence accessibility to healthcare and adherence to treatment of these diseases.